Secular trends in stillbirth by maternal socioeconomic status in Spain 2007–15: a population-based study of 4 million births

Stillbirth, one of the urgent concerns of preventable perinatal deaths, has wide-reaching consequences for society. We studied secular stillbirth trends by maternal socioeconomic status (SES) in Spain.We developed a population-based observational study, including 4 083 919 births during 2007–15. We estimate stillbirth rates and secular trends by maternal SES. We also evaluated the joint effect of maternal educational attainment and the Human Development Index (HDI) of women’s country of origin on the risk of stillbirth. The data and statistical analysis can be accessed for reproducibility in a GitHub repository: https://github.com/migariane/StillbirthWe found a consistent pattern of socioeconomic inequalities in the risk of delivering a stillborn, mainly characterized by a persistently higher risk, over time, among women with lower SES. Overall, women from countries with low HDIs and low educational attainments had approximately a four times higher risk of stillbirth (RR: 4.44; 95%CI: 3.71–5.32). Furthermore, we found a paradoxical reduction of the stillbirth gap over time between the highest and the lowest SESs, which is mostly due to the significant and increasing trend of stillbirth risk among highly educated women of advanced maternal age.Our findings highlight no improvement in stillbirth rates among women of lower SES and an increasing trend among highly educated women of advanced maternal age over recent years. Public health policies developing preventive programmes to reduce stillbirth rates among women with lower SES are needed as well as the necessity of further study to understand the growing trend of age-related stillbirths among highly educated women in Spain

Birthweight of babies born to migrant mothers - What role do integration policies play?

Birthweights of babies born to migrant women are generally lower than those of babies born to native-born women. Favourable integration policies may improve migrants’ living conditions and contribute to higher birthweights. We aimed to explore associations between integration policies, captured by the Migrant Integration Policy Index (MIPEX), with offspring birthweight among migrants from various world regions. In this cross-country study we pooled 31 million term birth records between 1998 and 2014 from ten high-income countries: Australia, Belgium, Canada, Denmark, Finland, Japan, Norway, Spain, Sweden and United Kingdom (Scotland). Birthweight differences in grams (g) were analysed with regression analysis for aggregate data and random effects models. Proportion of births to migrant women varied from 2% in Japan to 28% in Australia. The MIPEX score was not associated with birthweight in most migrant groups, but was positively associated among native-born (mean birthweight difference associated with a 10-unit increase in MIPEX: 105 g; 95% CI: 24, 186). Birthweight among migrants was highest in the Nordic countries and lowest in Japan and Belgium. Migrants from a given origin had heavier newborns in countries where the mean birthweight of native-born was higher and vice versa. Mean birthweight differences between migrants from the same origin and the native-born varied substantially across destinations (70 g–285 g). Birthweight among migrants does not correlate with MIPEX scores. However, birthweight of migrant groups aligned better with that of the native-born in destination counties. Further studies may clarify which broader social policies support migrant women and have impacts on perinatal outcomes.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Recherche et analyse des éléments moléculaires qui permettent aux toxines animales de lier les canaux KV1

ORSAY-PARIS 11-BU Sciences (914712101) / SudocPARIS-Museum Hist.Naturelle (751052304) / SudocSudocFranceF

Weak performance of glomerular filtration rate equations in stable lung/liver transplant recipients compared to 51Cr-EDTA clearance.

peer reviewe

Mothers’ experiences of perinatal care in Belgian public hospitals: exploring the social inequalities. Protocol for a cross-sectional survey

Introduction In Europe, the social inequalities in perinatal health are usually found to be to the disadvantage of non-European immigrants and women with lower levels of education and income. Among the possible underlying mechanisms are inadequate access to healthcare services and suboptimal care. To explore this hypothesis in the Belgian context, our research will describe detailed maternal socioeconomic and migration characteristics, explore how these factors relate to each other, and how they relate to women’s perinatal care trajectories and experiences of care.Methods Using a modified version of the Migrant-Friendly Maternity Care Questionnaire, we will survey 900 mothers of Belgian nationality or a nationality from a North or Sub-Saharan African country, and having given birth in four maternity wards in Brussels. The questionnaire has been adapted to the study objectives and the Belgian context. Interviewers will administer the 116-item questionnaire to all women agreeing to participate and meeting inclusion criteria, within 14 days of having given birth. Clinical information will be extracted from hospital records.Analysis We will estimate the associations of women’s socioeconomic and migration characteristics with:Women’s antenatal care trajectories (timing of first antenatal consultation, minimum recommended number of consultations, and problems accessing care).Obstetric practices such as episiotomies, emergency caesarean sections, and inductions.Patient experience such as feelings of discrimination, respect, and understanding of information.We will use descriptive statistics, multiple correspondence analysis, and simple and multiple logistic regressions.Ethics and dissemination Ethical approval has been obtained from the hospital Ethics Committees and from the Université libre de Bruxelles (No: P2017/055/B406201730877). Written informed consent will be sought from all participants.In addition to disseminating findings and recommendations to the scientific community through open-source journal articles and conferences, we will also address local organisations and healthcare professionals via a written report and seminars

migariane/Stillbirth: Analysis Stillbirth risk by SES in Spain

Background: Stillbirth, one of the urgent concerns of preventable perinatal deaths, has wide-reaching consequences for society. We studied secular stillbirth trends by maternal socioeconomic status (SES) in Spain. Methods: We developed a population-based observational study, including 4,083,919 births during 2007-2015. We estimate stillbirth rates and secular trends by maternal SES, using the fetuses-at-risk approach. We also evaluated the joint effect of maternal educational attainment and the Human Development Index (HDI) of women's country of origin on the risk of stillbirth. Results: We found a consistent pattern of socioeconomic inequalities in the risk of delivering a stillborn, mainly characterized by a persistently higher risk, over time, among women with lower SES. Overall, women from countries with low HDIs and low educational attainments had approximately a four-times higher risk of stillbirth (relative risk: 4.44; 95%CI:3.71, 5.32). Furthermore, we found a paradoxical reduction of the stillbirth gap over time between the highest and the lowest SESs, which is mostly due to the significant and increasing trend of stillbirth risk among highly educated women of advanced maternal age. Conclusion: Our findings highlight no improvement in stillbirth rates among women of lower SES and an increasing trend among highly educated women of advanced maternal age over recent years. The findings highlight the need for policymakers and health authorities to reduce health and social inequalities in stillbirth as well as the necessity of further study to understand the growing trend of age-related stillbirths among highly educated women in Spain

Analysis of caesarean section practices and consequences in Goma, DR Congo: Frequency, indications, maternal and perinatal morbidity and mortality

Introduction: Approximately 22.9 million Caesarean Sections (CS) are performed worldwide each year, mainly to save the life of the mother and/or new-born infant. However, with nearly 2 deaths in 1,000 live births, global neonatal mortality after CS is three times higher than after vaginal delivery. Nearly 300,000 women die every year as a result of a pregnancy or a caesarean or vaginal delivery. 99% of these maternal deaths occur in developing countries.Materials and methods: The study was conducted in the four referral hospitals in the city of Goma in DRC, between 01/11/2013 and 01/01/2016. Statistical analyses were performed using STATA/IC 15.0 for Windows. Univariate logistic regression was performed to determine which characteristics are associated with perinatal mortality. A value of p&lt;0.05 was considered statistically significant.Results: The overall frequency of CS in the four facilities was 16.2%. Goma Provincial Hospital had the highest frequency. The three main indications for CS were dystocia, scarred uterus and foetal distress. The most frequent intraoperative complications were haemorrhage and injury to nearby organs (bladder and digestive tract), and the most frequent post-operative complications were wound infections, urogenital fistulae and hypertensive disorders. Our study describes a perinatal risk of 4.4%.Conclusion: Caesarean section should be a factor in reducing foeto-maternal morbidity and mortality if transfer conditions, working conditions at referral centre level, and health staff training are improved.</p

Preliminary report of patients with meningiomas exposed to Cyproterone Acetate, Nomegestrol Acetate and Chlormadinone Acetate - Monocentric ongoing study on progestin related meningiomas.

The relationship between meningioma and progestins has not been elucidated. Meningioma regression after acetate cyproterone (CA) withdrawal has been reported. Our purpose was to evaluate the meningioma evolution after withdrawal of progestins in patients who underwent long-term exposure to CA, nomegestrol acetate (NA), chlormadinone acetate (ChlA).info:eu-repo/semantics/publishe